Background

A systematic review failed to identify any systemic therapy used in alopecia areata (AA) where use is supported by robust evidence from high-quality randomized controlled trials.

Objective

To produce an international consensus statement on the use and utility of various treatments for AA.

Methods

Fifty hair experts from 5 continents were invited to participate in a 3-round Delphi process. Agreement of 66% or greater was considered consensus.

Results

In the first round, consensus was achieved in 22 of 423 (5%) questions. After a face-to-face meeting in round 3, overall, consensus was achieved for only 130 (33%) treatment-specific questions. There was greater consensus for intralesional treatment of AA (19 [68%]) followed by topical treatment (25 [43%]). Consensus was achieved in 45 (36%) questions pertaining to systemic therapies in AA. The categories with the least consensus were phototherapy and nonprescription therapies.

Limitations

The study included a comprehensive list of systemic treatments for AA but not all treatments used.

Conclusion

Despite divergent opinions among experts, consensus was achieved on a number of pertinent questions. The concluding statement also highlights areas where expert consensus is lacking and where an international patient registry could enable further research.

中文翻译：

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脱发症专家共识研究（ACE）：国际专家对斑秃的治疗的意见。

背景

一项系统的审查未能确定在斑秃（AA）中使用的任何全身疗法，高质量的随机对照试验的有力证据支持了该疗法的使用。

目的

就AA的各种治疗方法的使用和效用发表国际共识声明。

方法

来自五大洲的50名头发专家应邀参加了3轮Delphi过程。66％或更高的协议被认为是共识。

结果

在第一轮中，共423个问题（5％）中的22个达成了共识。在第三轮的面对面会议之后，总体而言，仅针对130个治疗问题（33％）达成了共识。对于AA的病灶内治疗（19 [68％]），然后进行局部治疗（25 [43％]），共识更大。在机管局全身性治疗相关的45个问题（占36％）中达成了共识。共识最少的类别是光疗和非处方疗法。

局限性

该研究包括了全身抗AA治疗的综合清单，但并非所有使用的治疗都包括在内。

结论

尽管专家之间意见分歧，但在许多相关问题上达成了共识。结论性声明还强调了缺乏专家共识的领域以及国际患者注册系统可以促进进一步研究的领域。